[Solved] Can beta-blockers be combined with psilocybin?

Beta-blockers (β-blockers) such as Metoprolol (Lopressor, Toprol XL), Atenolol (Tenormin), Acebutolol, Bisoprolol, Nadolol (Corgard), Nebivolol (Bystolic), and Propranolol (Inderal) are primarily prescribed for heart conditions. Individuals with heart conditions are advised against taking psychedelic substances. Although medication falling under the beta-blocker category does not have a direct interaction with psilocybin, combining it with psilocybin can still be dangerous.

During the use of psilocybin, there is a chance of increased blood pressure while the psilocybin is taking effect (after conversion to psilocin). The extent to which blood pressure rises during this initial phase varies from person to person, but it can correspond to a heavy strength workout at the gym, such as a vigorous leg press. If someone can train hard at the gym, this may indicate that the increased blood pressure is not likely to be a problem.

Many people experience lowered blood pressure while the effects of psilocybin wear off. This can also persist the following day. This lowered blood pressure following psilocybin use, combined with the blood pressure-lowering effects of a beta-blocker, can lead to dangerously low blood pressure. Dangerously low blood pressure can result in dizziness, fainting, confusion, fatigue, and organ damage (in cases of extremely low blood pressure).

Whether a specific beta-blocker can be safely used with psilocybin depends on the condition of the heart and whether it can tolerate a temporary increase in blood pressure. It must also be determined whether the decrease in blood pressure following the wear-off of psilocybin could pose a problem.

Consult with your treating physician whether temporarily stopping beta-blockers is a good plan and safe in combination with the state of your heart condition, and whether psilocybin is safe for you.

The combination of beta-blockers and psilocybin is not inherently dangerous in terms of direct chemical interaction, but there are important medical considerations. Beta-blockers such as metoprolol, atenolol, propranolol, and bisoprolol are often prescribed for cardiovascular disease. It is precisely people with these conditions who are at increased risk when using psychedelics such as psilocybin.

During the rise of psilocybin (when it is converted into psilocin), blood pressure can temporarily rise significantly. This increase is comparable to the peak load during an intensive strength training session. If the heart is not well equipped to withstand such a temporary increase, it can pose risks.

At the end of the trip and also the day after, psilocybin can actually lower blood pressure. In combination with a blood pressure-lowering medication such as a beta-blocker, this can result in blood pressure that is too low (hypotension), which can lead to dizziness, fatigue, fainting, or even organ damage in the event of a severe drop.

Whether a combination is responsible therefore depends on the condition of your heart and blood pressure regulation. A medical assessment by your treating physician is essential., especially if you are considering temporarily stopping your medication. Discuss carefully whether the heart is able to handle the short-term blood pressure spike and whether the drop in blood pressure after the session will not lead to problems.